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Pathology > Autoimmunity > Flashcards

Autoimmunity Flashcards

7 pages - lecture 10

1
Q

define autoimmunity

A

the immune system attacks host components to cause pathological change. can be chronic and debilitating. considered a failure of self tolerance

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2
Q

4 organ specific autoimmune diseases

A 
1 - hashimoto's thyroiditis
2 - grace's disease
3 - pernicious anaemia - stomach
4 - type 1 diabetes - pancreas. 
may be as they are well vascularised and make organ specific proteins
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3
Q

give 3 non organ specific autoimmune diseases

A

1 - scleroderma - skin
2 - systemic lupus erythematosis
3 - rheumatoid arthritis

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4
Q

give the three types of autoimmuneity and their analogous hypersensitivity type

A

1 - direct antibody mediated effects - type 2 hypersensitivity
2 - immune complex mediated effects - similar to type 3
3 - T cell mediated - cellular

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5
Q

describe grave’s disease

A

type 1 - autoantibodies to the TSH receptor
- this stimulates unregulated synthesis of thyroid hormones as it decouples it from negative feedback on to the pituitary gland

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6
Q

describe myasthenia gravis

A

type 1 - autoantibodies to the ACh receptor

block ACh binding and cause receptor downregulation.

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7
Q

what is rheumatic fever ?

A

an example of direct tissue pathology following antibody binding. often follows a Streptococcus pyogenes infection.

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8
Q

cause of vasculitis?

A

deposition of autoantibody-antigen complexes

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9
Q

describe systemic lupus erythematosus

A

type 2 - patients have a variety of anticytoplasmic and antinuclear autoantibodies.
causes characteristic butterfly rash on the face.
can have significant complement depletion.
complement deficiencies that impair immune clearance are predisposing.
more common in african and asian women.

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10
Q

mechanisms of type 3, T cell mediated autoimmunity?

A

CD8 cytotoxicity, direct destruction by TNF, macrophage recruitment and bystander killing, induciton of apoptosis by Fas ligand.

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11
Q

what’s an EAE rat?

A

experimental autoimmune encephalomyelitis
- immunise rate with myelin basic protein in complete Freund’s adjuvant. Th1 CD4 cells specific to MBP are isolated and can cause disease if injected into another animal.

EAE resembles multiple sclerosis

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12
Q

what is autoimmune haemolytic anaemia?

A

autoantigen - Rh blood group antigens

consequence - destruction of RBC

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13
Q

what is goodpasture’s syndrome?

A

autoantigen - collagen type 4

consequence - glomerulonephritis

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14
Q

what is grave’s disease?

A

autoantigen - TSH receptor

consequence - hyperthyroidism

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15
Q

what is myasthenia gravis?

A

autoantigen - ACh receptor

consequence - progressive weakness

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16
Q

what is subacute baterial endocarditis?

A

autoantigen - bacterial antigen
consequence - glomerulonephritis
immune complex

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17
Q

what is SLE?

A

autoantigen - DNA, histones, ribosomes, snRNP, scRNP
consequence - glomerulonephritis, vasculitis, arthritis
immune complex

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18
Q

what is rheumatoid arthritis?

A

autoantigen - synovial joint antigens
consequence - joint inflammation and destruction
immune complex

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19
Q

what is multiple sclerosis?

A

autoantigen - myelin basic protein proteolipoprotein

consequence - brain degeneration and paralysis

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20
Q

autoimmune disease associated with HLA B27?

A

ankylosing spondylitis - RR of 90

goodpasture’s syndrome - RR of 10

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21
Q

autoimmune disease associated with DR2?

A

MS - RR of 5

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22
Q

autoimmune disease associated with DR3?

A

grave’s - RR 4
myasthenia gravis - RR2.5
SLE - RR 6

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23
Q

autoimmune disease associated with DR3/4?

A

T1D - RR3

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24
Q

autoimmune disease associated with DR4?

A

Rheumatoid arthritis - RR 4

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25
Q

endocrine factors of autoimmune diseases?

A

different frequencies in males and females. graves and hasimoto’s is 4-5 times more in females.
SLE is 10 times more in females
Anylosing spodylitis is 3-4 times more in males

26
Q

environmental factor to autoimmune diseases?

A

twin concordance rate is 20-40% for common diseases such as diabetes and rheumatoid arthritis. a likely factor is infection.
generally thought 50% environmental, 25% MHC, 25% other genes.

27
Q

example of autoimmunity due to release of sequestered antigen?

A

sympathetic ophthalmia - damage to one eye leads to subsequent attack of the contralateral eye

28
Q

what is T cell bypass, how might it occur?

A

autoimmunity due to T cell tolerance being bypassed:
1 - modification - generates a neoantigen by binding of pathogen to a self protein
2 - inflammation - APCs activated and anergic or ignorant autoreactive T cells may become activated.
3 - molecular mimicry - antibodies or T cells generated for an infectious agent cross react with self antigens.

29
Q

what’s a NOD mouse?

A

a spontaneous autoimmune disease model mouse that is inbred to make it suceptible to diabetes.
Non-obese diabetic mouse.

30
Q

what are Th17 cells?

A

they function predominantly in anti-microbial immunity at epithelial barriers an promote recruitment of neutrophils to sites of infection. they secrete IL-17.

believe to play a dominant role in autoimmune disease.

31
Q

what are Tfh cells?

A

T follicular helper cells - they localise in B cell follicles and activate B cells.
help cause isotype switching and affinity maturation.

32
Q

define autoimmunity

A

the immune system attacks host components to cause pathological change. can be chronic and debilitating. considered a failure of self tolerance

33
Q

4 organ specific autoimmune diseases

A 
1 - hashimoto's thyroiditis
2 - grace's disease
3 - pernicious anaemia - stomach
4 - type 1 diabetes - pancreas. 
may be as they are well vascularised and make organ specific proteins
34
Q

give 3 non organ specific autoimmune diseases

A

1 - scleroderma - skin
2 - systemic lupus erythematosis
3 - rheumatoid arthritis

35
Q

give the three types of autoimmuneity and their analogous hypersensitivity type

A

1 - direct antibody mediated effects - type 2 hypersensitivity
2 - immune complex mediated effects - similar to type 3
3 - T cell mediated - cellular

36
Q

describe grave’s disease

A

type 1 - autoantibodies to the TSH receptor
- this stimulates unregulated synthesis of thyroid hormones as it decouples it from negative feedback on to the pituitary gland

37
Q

describe myasthenia gravis

A

type 1 - autoantibodies to the ACh receptor

block ACh binding and cause receptor downregulation.

38
Q

what is rheumatic fever ?

A

an example of direct tissue pathology following antibody binding. often follows a Streptococcus pyogenes infection.

39
Q

cause of vasculitis?

A

deposition of autoantibody-antigen complexes

40
Q

describe systemic lupus erythematosus

A

type 2 - patients have a variety of anticytoplasmic and antinuclear autoantibodies.
causes characteristic butterfly rash on the face.
can have significant complement depletion.
complement deficiencies that impair immune clearance are predisposing.
more common in african and asian women.

41
Q

mechanisms of type 3, T cell mediated autoimmunity?

A

CD8 cytotoxicity, direct destruction by TNF, macrophage recruitment and bystander killing, induciton of apoptosis by Fas ligand.

42
Q

what’s an EAE rat?

A

experimental autoimmune encephalomyelitis
- immunise rate with myelin basic protein in complete Freund’s adjuvant. Th1 CD4 cells specific to MBP are isolated and can cause disease if injected into another animal.

EAE resembles multiple sclerosis

43
Q

what is autoimmune haemolytic anaemia?

A

autoantigen - Rh blood group antigens

consequence - destruction of RBC

44
Q

what is goodpasture’s syndrome?

A

autoantigen - collagen type 4

consequence - glomerulonephritis

45
Q

what is grave’s disease?

A

autoantigen - TSH receptor

consequence - hyperthyroidism

46
Q

what is myasthenia gravis?

A

autoantigen - ACh receptor

consequence - progressive weakness

47
Q

what is subacute baterial endocarditis?

A

autoantigen - bacterial antigen
consequence - glomerulonephritis
immune complex

48
Q

what is SLE?

A

autoantigen - DNA, histones, ribosomes, snRNP, scRNP
consequence - glomerulonephritis, vasculitis, arthritis
immune complex

49
Q

what is rheumatoid arthritis?

A

autoantigen - synovial joint antigens
consequence - joint inflammation and destruction
immune complex

50
Q

what is multiple sclerosis?

A

autoantigen - myelin basic protein proteolipoprotein

consequence - brain degeneration and paralysis

51
Q

autoimmune disease associated with HLA B27?

A

ankylosing spondylitis - RR of 90

goodpasture’s syndrome - RR of 10

52
Q

autoimmune disease associated with DR2?

A

MS - RR of 5

53
Q

autoimmune disease associated with DR3?

A

grave’s - RR 4
myasthenia gravis - RR2.5
SLE - RR 6

54
Q

autoimmune disease associated with DR3/4?

A

T1D - RR3

55
Q

autoimmune disease associated with DR4?

A

Rheumatoid arthritis - RR 4

56
Q

endocrine factors of autoimmune diseases?

A

different frequencies in males and females. graves and hasimoto’s is 4-5 times more in females.
SLE is 10 times more in females
Anylosing spodylitis is 3-4 times more in males

57
Q

environmental factor to autoimmune diseases?

A

twin concordance rate is 20-40% for common diseases such as diabetes and rheumatoid arthritis. a likely factor is infection.
generally thought 50% environmental, 25% MHC, 25% other genes.

58
Q

example of autoimmunity due to release of sequestered antigen?

A

sympathetic ophthalmia - damage to one eye leads to subsequent attack of the contralateral eye

59
Q

what is T cell bypass, how might it occur?

A

autoimmunity due to T cell tolerance being bypassed:
1 - modification - generates a neoantigen by binding of pathogen to a self protein
2 - inflammation - APCs activated and anergic or ignorant autoreactive T cells may become activated.
3 - molecular mimicry - antibodies or T cells generated for an infectious agent cross react with self antigens.

60
Q

what’s a NOD mouse?

A

a spontaneous autoimmune disease model mouse that is inbred to make it suceptible to diabetes.
Non-obese diabetic mouse.

61
Q

what are Th17 cells?

A

they function predominantly in anti-microbial immunity at epithelial barriers an promote recruitment of neutrophils to sites of infection. they secrete IL-17.

believe to play a dominant role in autoimmune disease.

62
Q

what are Tfh cells?

A

T follicular helper cells - they localise in B cell follicles and activate B cells.
help cause isotype switching and affinity maturation.

Pathology (38 decks)

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